Provider Demographics
NPI:1437376191
Name:MARSON, GIA MARIE (EDD)
Entity Type:Individual
Prefix:DR
First Name:GIA
Middle Name:MARIE
Last Name:MARSON
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4130 MURIETTA AVENUE
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91423-4223
Mailing Address - Country:US
Mailing Address - Phone:310-825-0768
Mailing Address - Fax:310-206-7265
Practice Address - Street 1:23632 CALABASAS ROAD
Practice Address - Street 2:SUITE 103
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302
Practice Address - Country:US
Practice Address - Phone:818-876-9927
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 18764103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling